The General Health Insurance Company (VZP) will reimburse hospitals for planned interventions without limits compared to the previous period. She informed about it in a press release today. He wants to enable hospitals to catch up on operations postponed by the two years of the covid-19 epidemic. During the epidemic, planned procedures were postponed, especially in cardiology, vascular surgery, gastroenterology, gynecology, urology or ORL.
Patients wait longer, for example, for operations on shoulder or knee ligaments, removal of polyps on the intestinal mucosa, restoration of the function of the ear drum, procedures to eliminate cardiac arrhythmia or the opening of narrowed blood vessels.
“For hospitalizations with selected elective care, covered by a flat-rate reimbursement, which is regulated by the reimbursement decree, we will therefore offer hospitals an individual reimbursement supplement to sign,” said Jan Bodnár, deputy director of VZP for healthcare. VZP covers the care of about 60 percent of the population, the rest is shared by six other smaller insurance companies.
In further care, this year’s reimbursement decree introduces reimbursement for the number of services, not a flat rate as in previous years. Without regulation, insurance companies pay, for example, for hip joint replacement, gallbladder removal, hernia surgery, cancer surgery or other cardiac, cardiosurgical, vascular or gynecological operations. Likewise, transplants, surgeries for birth defects or interventions related to injuries are not restricted.
Nevertheless, the Ministry of Health is preparing the possibility of retroactively adjusting the payment of health insurance companies for care this year again by means of a compensation decree. He submits to the House of Representatives a compensation law enabling the issuance of a compensation decree. In addition to hospitals with acute beds, it could also apply to follow-up care.
The reimbursement decree for 2022 was issued last October according to the results of meetings between representatives of insurance companies and individual health care segments in the first half of 2021. can be predicted quite accurately, its unconditional application when calculating reimbursements (…) could cause significant economic problems for some health service providers,” the ministry said.
If the expected autumn waves of the epidemic increase the number of patients with covid-19 again, reimbursements to hospitals could fall by approximately 1.1 billion crowns, against the plan by about 1.8 percent. Even without the autumn wave, the shortfall would be in the order of hundreds of millions of crowns.
Due to the postponement of planned operations, for example orthopedic or cardiology, fewer patients come to follow-up care, for example rehabilitation institutions or hospitals for long-term patients. In 2021, their payments fell by about three billion crowns. According to the ministry, this year’s decline could be almost comparable. In total, 28.3 billion crowns were planned for this segment this year.
The Ministry justifies the need to compensate hospitals for the drop in care by the same personnel costs, which make up from 40 to 90 percent of care costs. “By laying off health workers, the capacity of the provider would be reduced in the future, and thus the availability of health services, which is not systemically desirable. A large part of the other costs are also fixed,” the ministry said. Fixed costs are also amounts for the operation of buildings, for example energy, the prices of which have been rising dramatically recently.
In a possible compensation decree, the Ministry does not expect that any segment would be compensated with higher costs due to covid-19.
Source: CTK
